Senate Bill 192
By: Senators Esteves of the 35th, Halpern of the 39th, Jones II of the 22nd, Jackson of the
41st, Parent of the 44th and others
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to
insurance generally, so as to require the Department of Insurance to implement a certain
insurance affordability program in response to the pending expiration of certain Patient
Protection and Affordable Care Act tax credits; to provide for definitions; to provide for
automatic repeal; to provide for related matters; to provide for a short title; to provide for
legislative findings; to provide for an effective date; to repeal conflicting laws; and for other
purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
This Act shall be known and may be cited as the "Georgia Health Insurance Affordability
and Consumer Protection Act."
SECTION 2.
The General Assembly finds and declares that:
(1) The enhanced premium tax credits (ePTCs) under the federal Patient Protection and
Affordable Care Act, also known as the "ACA," have significantly increased the
affordability of health insurance for low- and middle-income Georgians, reducing the
state's uninsured rate;
(2) Without Congressional action, the ePTCs will expire on December 31, 2025, and
thousands of Georgians, particularly those earning under 250 percent of the federal
poverty level, will experience drastic premium increases, making health insurance
unaffordable and increasing the number of uninsured individuals;
(3) The expiration of these tax credits would disproportionately harm rural communities,
small business owners, gig workers, and historically marginalized populations;
(4) Several states, including New Mexico, Colorado, and Washington, have implemented
state based affordability programs to provide premium and cost-sharing assistance to
mitigate rising health insurance costs;
(5) Georgia must act swiftly to prevent gaps in affordability and ensure continued access
to affordable health insurance for its residents; and
(6) The purpose of this Act is to direct the Georgia Department of Insurance to establish
a program within statutory requirements established by law to lessen the impact of the
ePTCs' expiration, ensuring Georgians continue to have access to affordable, high quality
health coverage in 2026.
SECTION 3.
Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to insurance
generally, is amended by adding a new Code section to read as follows:
<ins>"33-24-59.34.
(a) As used in this Code section, the term:
(1) 'Affordability program' means the program administered by the department to reduce
the cost of health insurance for Georgians through premium assistance, cost-sharing
reductions, reinsurance, or other financial mechanisms.
</ins>
<ins>(2) 'Cost-sharing reductions' means state or federal subsidies that lower out-of-pocket
costs, such as deductibles and copayments, for eligible individuals.
(3) 'Federal poverty level' means the income thresholds updated annually by the United
States Department of Health and Human Services.
(4) 'Georgia Access' means the state based health insurance marketplace established
under the federal Patient Protection and Affordable Care Act.
(5) 'Qualified health plan' or 'plan' means a health insurance plan certified to be offered
through Georgia Access.
(b) The department shall develop an affordability program by September 30, 2025, which
shall include:
(1) State premium subsidies to replace or supplement federal premium tax credits for
enrollees earning up to 400 percent of the federal poverty level;
(2) Other cost-sharing reductions for individuals earning below 250 percent of the
federal poverty level which may include lower deductibles, copays, and other
out-of-pocket expenses; and
(3) A state funded plan for individuals earning below 200 percent of the federal poverty
level that does not require the payment of any premiums.
(c) The department shall convene a stakeholder working group by July 1, 2025, consisting
of consumer advocates, health insurers, healthcare providers, and employers to develop a
consumer centered approach to the affordability program.
(d) The department shall submit the stakeholder working group's plan for the affordability
program to the Governor and General Assembly by September 30, 2025. Such submission
shall include recommendations for additional ways to reduce the cost of health insurance.
(e) The department shall promugate rules and regulations for implementation of the
affordability program by December 1, 2025.
(f) The department, in coordination with the Office of Planning and Budget, shall conduct
a fiscal impact analysis by August 1, 2025, and identify sustainable funding mechanisms
</ins>
<ins>for the affordability program, including appropriations by the General Assembly and
charges on health insurers offering plans on Georgia Access. The results of such analysis
shall be contained in a report, along with the financial structure and projected impact of the
affordability program, which shall be submitted to the Governor and General Assembly by
September 1, 2025.
(g) Beginning on January 1, 2027, the department shall provide annual reports to the
General Assembly detailing:
(1) The number of Georgians receiving assistance through the affordability program;
(2) The impact of the affordability program, enrollment rates, and health outcomes; and
(3) Any recommended changes or expansions to such program.
(h) The department shall implement consumer education and outreach initiatives to ensure
eligible Georgians are aware of and can access the affordability program.
(i) The department shall conduct a comprehensive evaluation in 2029 to assess the
program's impact and determine the need for continuation or adjustments. The results of
such evaluation shall be submitted to the Governor and General Assembly in a report by
January 1, 2030.
(j) The affordability program shall only become effective on January 1, 2026, in the event
that the United States Congress allows the enhanced premium tax credits under the federal
Patient Protection and Affordable Care Act to expire on December 31, 2025. In the event
that the affordability program does not become effective, none of the reports required in
this Code section shall be applicable.
(k) This Code section shall stand repealed on December 31, 2030."
</ins> SECTION 4.
This Act shall become effective upon its approval by the Governor or upon its becoming law
without such approval.
SECTION 5.
All laws and parts of laws in conflict with this Act are repealed.